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ESA 3 - HPHD > Adherence To Treatment > Flashcards

Flashcards in Adherence To Treatment Deck (47)
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1

Define compliance.

Compliance is the extent to which the patient complies with medical advice.

2

Define adherence.

The extent to which patient behaviour coincides with medical advice.

3

What is the difference between compliance and adherence?

Compliance involves the patient "doing as they are told", adherence takes into account the patients right to choose to what extent they follow the advice.

(Often used interchangeably in practice however)

4

Define concordance.

Negotiation between the patient and doctor over treatment regimes.

5

What does concordance imply?

That the patient is active and in partnership with the doctor

6

What does concordance allow for?

The patient's beliefs and priorities to be respected and for decisions to be shared

7

How may concordance lead to adherence?

- The patient has involvement and shared ownership of decisions.

- Patient's beliefs, expectations, lifestyle and priorities are considered.

- Barriers to adherence can be addressed.

-Promotes trust and satisfaction with care.

8

What is the norm in terms of adherence to medical advice?

Non-adherence is the norm

9

What percentage of chronically ill patients do NOT adhere to medical advice?

50%

10

What percentage of hospitals admissions of chronically ill patients are due to non-adherence?

10-25%

11

What is the percentage of non-adherence to medication?

~21%

12

What is the percentage of non-adherence to exercise?

~28%

13

What is the percentage of non-adherence to diet?

~42%

14

Which diseases have the highest rates of adherence?

HIV, arthritis, GI disorders, and cancer

15

Which diseases have the highest rates of non-adherence?

Pulmonary disease, diabetes, and sleep disorders

16

Give two examples of direct measures of adherence

Urine or blood test

Observation (e.g. Of consumption)

17

What are the advantages of urine or blood tests?

Provides a direct measure of consumption/adherence

18

What are the disadvantages of urine or blood tests?

Expensive

Limited to use in clinical practice

Invasive

19

What are the advantages of direct observation of adherence?

Provides a direct measure of consumption/adherence

20

What are the disadvantages of direct observation of adherence?

Expensive

Limited to use in clinical practice

Invasive

21

Give four examples of indirect measures of adherence

Pill counts

Mechanical or electrical measures of dose dispensing

Patient self-report

Second-hand reports

22

What is the advantage of pill counts?

More objective than self / other-reports

23

What is the disadvantage of pill counts?

Still subject to inaccuracy (e.g. Lost pills)

24

What are the advantages of mechanical or electrical measures of dose dispensing?

Objectively measures whether a dose has been dispensed

More accurate than other indirect measures

25

What is the disadvantage of mechanical or electrical measures of dose dispensing?

Doesn't measure if the dispensed medication was actually taken

26

What are the advantages of patient self-report?

Easy to obtain

Inexpensive

27

What are the disadvantages of patient self-reports?

Prone to inaccuracies/bias

Tendency to over-report adherence

28

What are the advantages of second-hand reports?

Similar to self-reports

29

What are the disadvantages of second-hand reports?

Similar to self-reports

Also depends on familiarity with patient

30

What are the main contributing factors for non-adherence?

Illness factors

Treatment factors

Patient factors

Psychosocial factors

Healthcare factors